12355 West Virginia University School of Medicine, Morgantown, WV, USA.
5631 Division of Cardiovascular and Thoracic Anesthesiology, West Virginia University, Morgantown, WV, USA.
Innovations (Phila). 2021 Jul-Aug;16(4):390-392. doi: 10.1177/15569845211003095. Epub 2021 Apr 20.
Quadricuspid aortic valve (QAV) is a rare congenital anomaly often associated with aortic insufficiency. The exact anatomy of QAV is variable, and most cases have undergone aortic valve replacement. With the recognition that aortic valve repair achieves superior patient outcomes as compared to replacement, a systematic approach to autologous reconstruction of QAV is needed. This article reports 2 cases having successful repair utilizing geometric aortic annuloplasty rings, and describes a proposed scheme for repairing most QAV defects, based on relative leaflet and commissural characteristics. Using either tri-leaflet or bicuspid ring annuloplasty, the normal sub-commissural triangles can be remodeled into a 120° or 180° configuration, respectively, and then the leaflets can be sutured and plicated to fit annular geometry. With this approach, most quadricuspid valves potentially could undergo autologous reconstruction.
三尖瓣畸形主动脉瓣（QAV）是一种罕见的先天性异常，常伴有主动脉瓣关闭不全。QAV 的确切解剖结构多变，大多数病例已行主动脉瓣置换术。由于认识到主动脉瓣修复术比置换术能取得更好的患者预后，因此需要对 QAV 进行自体重建的系统方法。本文报告了 2 例利用几何主动脉瓣环成形术成功修复的病例，并根据相对瓣叶和连合特征，描述了一种修复大多数 QAV 缺陷的建议方案。使用三叶瓣或双瓣环瓣环成形术，可分别将正常次连合三角重塑为 120°或 180°构型，然后可缝合和折叠瓣叶以适应环形几何形状。通过这种方法，大多数三尖瓣畸形主动脉瓣都有可能进行自体重建。
